| NPI | 1306690920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XIOMARA JACQUELINE PORRAS Provider 405-408-2152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-04-11 |